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Industrial Psychiatry Journal Oct 2021"" An adage was brought to life with the emergence of the mRNA vaccine against the backdrop of the foreboding and mercurial COVID-19 pandemic. Considering a negligible...
"" An adage was brought to life with the emergence of the mRNA vaccine against the backdrop of the foreboding and mercurial COVID-19 pandemic. Considering a negligible adverse-effect profile and a break-neck manufacturing speed, it shone bright as the ideal vaccine candidate. However, "," as was evidenced by the significant reactogenicity, a host of multi-systemic side-effects, that are being reported by the vaccine recipients; which is palpably resulting in a shift of emotions for the vaccine, accounting for vaccine hesitancy. Anaphylaxis, antibody-dependent enhancements, and deaths, comprise the most serious side-effects, albeit occurring in sparing numbers. Storage and transportation require fastidious temperatures, rendering it substantially inaccessible to a country like India. The biggest jolt, however, was the unfolding of the biases in reporting vaccine efficacy, as only the attractively high numbers of the relatively equivocal relative risk reduction were reported while keeping at bay the meager numbers of the more forthright absolute risk reduction. Notwithstanding the fallacies, the mRNA vaccine still promises hope; and with the right precautions and finesse, can be potentiated, as "."
PubMed: 34908713
DOI: 10.4103/0972-6748.328833 -
The Medical Journal of Australia Jul 1986It is widely accepted that a palpable spleen in the adult population is always enlarged and pathological. The aim of this study was to assess the validity of this...
It is widely accepted that a palpable spleen in the adult population is always enlarged and pathological. The aim of this study was to assess the validity of this statement. As a routine, our protocol for liver-spleen studies includes liver pliability, which demonstrates the level of the hemidiaphragms at full inspiration and expiration, as well as splenic size and colloidal uptake. Sixteen hundred 99mTc sulphur colloid liver-spleen studies, which had been performed in our Department, were reviewed. In 21 patients, who had been referred with "splenomegaly for investigation", the scintigraphic splenic size was 13 cm posterior length or less. In this group, splenic palpability was confirmed by at least two clinicians. Follow-up did not reveal any evidence of splenic disease in 18 of the 21 patients. In a separate postmortem follow-up of 123 sequential liver-spleen scans, 100 patients were noted to have a scintigraphic splenic size of 13 cm posterior length or less. This was shown to be a reliable upper limit of normal because 98% of spleens in this group weighed 250 g or less and were normal at post-mortem examination. This study demonstrates that a palpable spleen is not necessarily enlarged or pathological.
Topics: Adult; Aged; Female; Humans; Liver; Liver Diseases; Male; Middle Aged; Palpation; Radionuclide Imaging; Spleen; Splenomegaly; Technetium Tc 99m Sulfur Colloid
PubMed: 3724622
DOI: 10.5694/j.1326-5377.1986.tb113733.x -
Southern Medical Journal Jul 1996Physicians in the United States may encounter Hansen's disease in immigrants and areas such as Texas, Louisiana, Hawaii, and California. Exposure to infected armadillos... (Review)
Review
Physicians in the United States may encounter Hansen's disease in immigrants and areas such as Texas, Louisiana, Hawaii, and California. Exposure to infected armadillos may be one means of acquiring the disease. The Mycobacterium leprae bacillus has a predilection for nerves and skin in the cooler areas of the body. The limited tuberculoid form of the disease is characterized by one or a few hypoesthetic skin lesions and palpably enlarged nerves. The more extensive lepromatous form of the disease appears as multiple nodular skin lesions, sometimes with involvement of the nasal structures and eye. Current recommended regimens for treatment of Hansen's disease are based on combinations of dapsone, rifampin, and clofazimine. Recent advances in treatment have resulted in a significant decline in the worldwide prevalence of the disease.
Topics: Adult; Humans; Leprosy; Male; Middle Aged
PubMed: 8685748
DOI: 10.1097/00007611-199607000-00001 -
The Journal of Vascular Access Jan 2023The increase in the success rate of peripheral intravenous catheterization against a difficult intravenous access (DIVA) using ultrasonography is reported; however,...
BACKGROUND
The increase in the success rate of peripheral intravenous catheterization against a difficult intravenous access (DIVA) using ultrasonography is reported; however, reports related to the effectiveness of using ultrasonography in increasing the success rate for visible and palpable veins is limited. Furthermore, according to a previous study, first attempt success in catheterization contributes to low catheter failure incidence. Thus, we developed a catheterization method using ultrasonography for peripheral veins including visible and palpable veins. This study investigates the effectiveness of ultrasonography use in improving the success rate of catheterization and preventing the catheter failure for peripheral veins including visible and palpable veins.
METHODS
Adult inpatients were recruited. Trained nurses inserted intravenous catheters using ultrasonography. Ultrasonography was used for all vein assessment, target vein selection, and puncturing (i.e. target point selection and/or needle guidance), regardless of the target vein's visibility or palpability. Catheters with over a 24-h dwelling time were followed for catheter failure incidence.
RESULTS
Thirty-one patients were recruited, and they required 34 catheterizations. Total number of catheterization attempts were 39. Of the peripheral veins, 51.3% (20/39) were visible and palpable, 48.7% (19/39) were DIVA. The rate of successful intravenous cannulation was 29 of 34 (85.3%) after one attempt and 4 of 34 (total 97.0%) after two attempts. The catheterization failure incidence was 3.2% (1/31) in the catheter that had an over 24-h dwelling time.
CONCLUSIONS
Using ultrasonography to all target veins might have contributed to higher success rates of catheterization and extremely low incidence of catheter failure based on objective findings. Selecting the vein with larger diameters and healthy tissue as puncture point and showing center of vessel lumen clearly using ultrasonography might have been contributed the results.
Topics: Adult; Humans; Veins; Catheters; Catheterization, Peripheral; Ultrasonography; Infusions, Intravenous; Ultrasonography, Interventional
PubMed: 34075824
DOI: 10.1177/11297298211022078 -
Harefuah Jan 2016Cryptorchidism is the most common genitourinary disorder in male neonates, with an incidence of 2-5% in term neonates and 30% in preterm infants. Known complications of...
INTRODUCTION
Cryptorchidism is the most common genitourinary disorder in male neonates, with an incidence of 2-5% in term neonates and 30% in preterm infants. Known complications of this condition include impaired fertility and an increased risk of malignancy. This leads to a high frequency of imaging tests, specifically ultrasonography. Use of ultrasound aims to identify non-palpable testis, however current literature does not support such an approach.
GOALS
To evaluate the efficacy of clinical follow-up of cryptorchidism in neonates and to evaluate the need for ultrasonography.
METHODS
This prospective study was performed at the Lis Maternity Hospital in the Tel Aviv Sourasky Medical Center during a 14 month period. During that period some 4,500 male neonates were born at our hospital. Every newborn was examined within 8 hours of delivery by a pediatrician skilled in neonatal physical examinations. Excluded from the study were preterm infants, neonates in which prenatal examination demonstrated genitourinary abnormalities and neonates with additional congenital abnormalities. Healthy term babies in which one or both testes were not palpable were re-examined within a day by a senior neonatologist (M.B.) to establish their diagnosis, and then reexamined daily by the same physician until their discharge from the hospital. Babies who had one or both testis which were not palpable on discharge were followed-up weekly at a hospital clinic for 2 more weeks.
RESULTS
Of 4,500 male neonates born during the study period, 41 (0.9%) were diagnosed with a non-palpable testis, and 8 (0.18%) had bilateral non-palpable testes; 5 babies were lost to followup and excluded from the analysis; 26 of 44 testes (29%) became palpable before discharge from the nursery, by the 3rd day of life. After a weekly follow up from discharge, 13 (29%) additional testes became palpable over the 4-14th day of life. Overall, 88% of non-palpable testes became palpable by 14 days of age.
CONCLUSIONS
Close clinical follow-up during the first weeks after birth allows localizing most congenitally non-palpable testing and clarifying the need for performing imaging studies not routinely necessary to diagnose and refer babies with cryptorchidism for further treatment.
Topics: Cryptorchidism; Follow-Up Studies; Humans; Infant, Newborn; Israel; Male; Physical Examination; Prospective Studies; Testis
PubMed: 27012066
DOI: No ID Found -
Breast Cancer Research and Treatment May 2024Due to the establishment of screening mammography for breast cancer detection, the number of non-palpable lesions has increased. Thus, an optimal localization system is...
BACKGROUND
Due to the establishment of screening mammography for breast cancer detection, the number of non-palpable lesions has increased. Thus, an optimal localization system is mandatory for the excision of non-palpable breast tumors.
OBJECTIVE
The aim of the study is to report the feasibility Surgical Marker Navigation (SMN) system Sirius Pintuition® for the excision of non-palpable breast tumors and non-palpable axillary lymph nodes.
METHODS
A retrospective observational study of patients undergoing breast-conserving surgery and lymph node excision guided by SMN between December 2022 and May 2023 was performed.
RESULTS
A total of 84 patients underwent excision of non-palpable breast tumors (77; 91.7%) or non-palpable axillary lymph-nodes (7; 8.3%) using SMN. In total, 94 markers were placed, in 74 patients (88.1%) only one marker was placed, whereas in 10 patients (11.9%) two markers were placed to correctly localize the lesion in the operating room. Most markers were placed using ultrasonographic guidance (69; 82.1%). Seventy-seven patients underwent breast-conserving surgery (91.7%) and 7 (8.3%) lymph node excision. In 10 cases (11.9%), the marker was accidentally displaced during surgery due to the use of magnetized instruments, although the specimen could be removed. In sum, all the markers were removed from the patients, although the marker retrieval rate, as we defined it (percentage of patients in whom the initial excised specimen contained the marker divided by the total number of patients), was 88.1%.
CONCLUSION
The use of Sirius Pintuition® SMN for non-palpable breast tumors and non-palpable lymph nodes is feasible, with a retrieval rate of 88.1%.
PubMed: 38806876
DOI: 10.1007/s10549-024-07382-y -
Central European Journal of Urology 2022Small testicular lesions ≤20 mm (STL) detected by ultrasound (US), usually non-palpable, have been reported to be benign in up to 80% of cases. Thus, partial...
INTRODUCTION
Small testicular lesions ≤20 mm (STL) detected by ultrasound (US), usually non-palpable, have been reported to be benign in up to 80% of cases. Thus, partial orchiectomy with or without frozen section examination and surveillance has been advocated for these kinds of lesions. We seek to report the proportion of benign lesions in testicular tumors ≤20 mm detected by US in our population and explore the predicting factors of malignancy.
MATERIAL AND METHODS
A retrospective descriptive study of orchiectomies performed for testicular tumors in patients older than 15 years between 2005 and 2019 was performed, including all patients with lesions ≤20 mm on US imaging.
RESULTS
A total of 70 patients with STL were included (mean age 34.6 ±10.8 years). Overall, 69% of the lesions were malignant while the smallest lesions (≤10 mm) showed 61% of cancer. Moreover, in the subgroup of non-palpable lesions ≤10 mm, 50% were malignant. Multifocal tumors were found in 18 subjects with a malignancy rate of 88%. There was a significant association between maximum size on US, multifocality and malignancy. Neither tumor markers nor palpability foretold a malignant lesion. A predictive model including size and multifocality was created showing a positive predictive value of 83.3%.
CONCLUSIONS
US maximum size and multifocality were predictors of malignancy in STL. However, even the smallest lesions showed a 50% chance of being malignant, thus surgery with or without intraoperative biopsy is warranted in most cases.
PubMed: 35591957
DOI: 10.5173/ceju.2022.0206 -
American Journal of Surgery Oct 2003This study evaluates the safety, efficacy, and patient acceptance of a vacuum-assisted, hand-held biopsy device (Mammatome) in the percutaneous removal of breast masses... (Clinical Trial)
Clinical Trial
BACKGROUND
This study evaluates the safety, efficacy, and patient acceptance of a vacuum-assisted, hand-held biopsy device (Mammatome) in the percutaneous removal of breast masses using ultrasound guidance.
METHODS
A multicenter, nonrandomized study evaluated 216 women with low-risk palpable lesions. Lesions 1.5 to 3.0 cm in size were removed using an 8-gauge probe. Those lesions <1.5 cm were removed with the 11-gauge probe. Follow-up evaluation was performed at 10 days and 6 months after biopsy.
RESULTS
A total of 127 patients had biopsies using the 8-gauge probe, and 89 patients had biopsies using the 11-gauge probe. At 6-month follow-up, 98% of the lesions remained nonpalpable, 73% with no ultrasonographically visible evidence of the original lesion. Most complications were mild and anticipated. Most patients (98%) were satisfied with incision appearance, and 92% of patients would recommend the procedure to others.
CONCLUSIONS
Percutaneous removal of palpable benign breast masses using the Mammotome system is feasible and safe, and yields high patient satisfaction. The results at 6 months after biopsy demonstrated the effectiveness of benign lesion removal, with correlative clinical data demonstrating lack of palpability and no need for additional procedures. Continuing evaluation of long-term efficacy is ongoing.
Topics: Adult; Biopsy; Breast Neoplasms; Female; Humans; Patient Satisfaction; Risk Factors; Ultrasonography, Interventional; Vacuum
PubMed: 14553851
DOI: 10.1016/s0002-9610(03)00263-0 -
Urology Dec 1993The role of ultrasound in the diagnosis of prostate cancer is still evolving. We used ultrasound to examine 202 patients with palpably abnormal prostates. Of 151... (Comparative Study)
Comparative Study Review
The role of ultrasound in the diagnosis of prostate cancer is still evolving. We used ultrasound to examine 202 patients with palpably abnormal prostates. Of 151 patients undergoing biopsy, ultrasound-guided biopsy was comparable to digitally directed biopsies in cancer detection (92% vs 90.7%). The two methods are complementary and should both be considered in patients with palpably abnormal prostates.
Topics: Adenocarcinoma; Biopsy; Humans; Male; Palpation; Predictive Value of Tests; Prospective Studies; Prostatic Neoplasms; Rectum; Sensitivity and Specificity; Ultrasonography
PubMed: 8256400
DOI: 10.1016/0090-4295(93)90532-f -
Translational Andrology and Urology Oct 2017Positron emission tomography (PET) imaging with F-fluorodeoxyglucose (FDG) combined with computed tomography (CT) provides functional imaging combined with anatomic... (Review)
Review
Positron emission tomography (PET) imaging with F-fluorodeoxyglucose (FDG) combined with computed tomography (CT) provides functional imaging combined with anatomic information, improving diagnostic accuracy and confidence. Although virtually all primary penile tumors are FDG-avid, PET/CT is not recommended for primary tumor staging as it has limited spatial resolution and is hampered by urinary FDG excretion. The accuracy of PET/CT for lymph node staging seems to improve with the pretest likelihood of metastatic nodes. In groins with normal physical examination, sensitivity is only 57%. In groins with palpably enlarged lymph nodes, sensitivity of PET/CT reaches 96%. For pelvic lymph nodes and distant metastases, PET/CT is more accurate if inguinal metastases are present. However, these results are based on a very limited number of studies. Overall, the role of PET/CT imaging in penile cancer remains ambiguous, especially in inguinal lymph nodes. During staging and follow-up, it may be particularly useful in detecting pelvic lymph node metastases and occult distant metastases prior to systemic chemotherapy and/or extensive surgery, improving selection of patients that are most likely to benefit from such therapies.
PubMed: 29184780
DOI: 10.21037/tau.2017.04.36